Every question we get before a switch.Answered straight.

Statewise is an AI-native Medicaid EHR and EVV platform purpose-built for home and community-based services (HCBS) providers - IDD services, pediatric private duty nursing, pediatric therapy, and personal care. It runs scheduling, clinical documentation, state forms, electronic visit verification, Medicaid billing, and compliance in one connected system instead of the disconnected tools most agencies stitch together.

HCBS providers billing Medicaid: IDD and waiver agencies (day habilitation, residential, community and employment supports), pediatric private duty nursing, pediatric therapy (PT/OT/speech), and personal care. If your revenue depends on Medicaid waivers and EVV rather than Medicare, the platform is built around your programs and codes - not adapted from a home health model.

Most EHRs are built around Medicare home health workflows and then stretched to cover Medicaid. Statewise is built the other way around - around IDD programs, pediatric care, and the Medicaid waiver and EVV rules that actually govern your claims. That means the authorizations, service codes, EVV models, and state forms you work with are first-class, not a bolt-on.

Scheduling, point-of-care and clinical documentation, electronic visit verification, state form and authorization tracking, Medicaid claims and billing, payment posting and 835 reconciliation, and compliance reporting - all in one platform. An optional managed Billing Services team can run the revenue cycle for you.

Pricing starts at $1,000/month and scales with your organization size, vertical mix, and how many states you operate in. EVV, billing, documentation, scheduling, and implementation are included. Book a call for a quote tailored to your programs and volumes.

Providers typically go live in about 14 weeks. Implementation covers data migration, state EVV and aggregator setup, payer and authorization configuration, and staff training - so you switch on a schedule instead of an open-ended project.

Claims are built from the documentation and visit data your caregivers already capture. The platform matches each service to the correct code, authorization, and units, scrubs it against payer and state rules before submission, and routes remittances back for posting - so clean claims go out the first time and your staff stops re-keying data between systems.

Statewise providers run a 99.6% clean claim rate - the share of claims accepted on first submission without rejection or rework. A high clean claim rate is the single biggest driver of predictable cash flow, because every rejected claim means staff time to correct and resubmit and days added to your A/R.

Because EVV capture and billing live in the same platform, visit data flows straight into the claim - no exporting from one system and importing into another. That closes the handoff gaps where hard-edit rejections come from: mismatched service codes, GPS or location data that doesn't align with the visit, unauthorized units, and caregiver credentials not linked to the record. Exceptions surface during service delivery, not in a rejection report weeks later.

The HCBS codes providers bill every day - personal care and attendant services (T1019, T2025), day habilitation (T2021), residential habilitation (T2016/T2020), and community-based supports - plus therapy and nursing services, authorization tracking, and 835 electronic remittance posting and reconciliation. Codes and modifiers are configured to your state's specific requirements.

When a claim comes back, it's flagged with the reason, corrected, and resubmitted or appealed where warranted - denied claims get worked to resolution instead of aging out on a worklist. With optional managed Billing Services, our in-house revenue-cycle team does that work for you and delivers a reconciled Month-End Close and reporting.

Yes. Statewise Billing Services is a done-for-you option where our in-house team handles submission, scrubbing, resubmission, denial and appeal management, payment posting, 835 reconciliation, and month-end close - while you keep full visibility into claim status, A/R, and collections through dashboards and reporting.

Yes. The Cures Act requires states to verify the six core EVV data elements for Medicaid personal care and home health visits - service type, individual receiving care, date, location, caregiver identity, and start/end times. Statewise captures all six at the point of service and transmits them to your state's EVV system or aggregator in the required format.

Statewise supports providers across 38 states. Each state's EVV model, approved aggregator, service codes, and validation rules are configured for you, so a multi-state agency isn't reconciling three different systems by hand.

EVV is not uniform - states run open-vendor, state-mandated, MCO-choice, and provider-choice models, and route data through different aggregators and portals (for example Sandata and HHAeXchange, or state systems like Texas TMHP, Pennsylvania PROMISe, New York eMedNY, and California DHCS). Statewise is configured to your state's specific model and aggregator, and validates records against that state's rules before claims go out.

IDD supports are often delivered in the community - a job site, a family visit, a day program, or an activity that crosses county lines - so a static home address creates false GPS exceptions in systems built for home health. Statewise supports location verification for community-based services and reconciles it against the authorized service, so legitimate visits pass validation instead of piling up as exceptions your billing staff has to clear.

Yes. State forms, plan and authorization documents, and required signatures are tracked in the platform and tied to the visits and claims they support. Authorization tracking checks units and dates against what the payer approved, so you catch a shortfall before you deliver unbillable service - not after the claim denies.

A hard edit is an automated rule that rejects a claim before payment when EVV data is missing or doesn't match the claim - unlike a soft edit, which only warns. Many states have moved from soft to hard edits, and some set compliance thresholds (for example 75% EVV compliance) with monitoring consequences. Statewise keeps EVV and billing connected so records are complete and matched before submission, which is what passing hard edits requires.

Yes. Statewise is built to HIPAA's privacy and security requirements for protected health information, and we sign a Business Associate Agreement (BAA) with every provider. Safeguards, access, and breach-notification obligations are handled as core platform requirements, not afterthoughts.

PHI is encrypted in transit and at rest, access is governed by role-based permissions so staff only see what their role requires, and activity is captured in audit logs. Our Trust Center documents the platform's security posture and controls so your compliance team can review them directly.

You do. Access is role-based and administered by your organization - you decide which staff can view, edit, or export records - and every access and change is logged so you have an audit trail for state reviews and internal oversight.

Your data is yours. Statewise stores your clinical, EVV, and billing records and supports export and reporting, so you're never locked in and can meet audit, migration, or reporting requests without a fight.

Because documentation, EVV records, authorizations, and claims live in one connected system, an audit request is a report you pull rather than a reconstruction across disconnected tools. Visit data, signatures, authorizations, and the claims they support stay linked, so you can demonstrate a complete, verifiable record.

We migrate your client and staff records, configure your states' EVV and payer requirements, and train your team through a structured implementation that typically reaches go-live in about 14 weeks. You move on a defined schedule with your history intact.

Yes - multi-state operation is a core reason providers choose Statewise. Each state's EVV model, aggregator, codes, and rules are configured centrally, so your team works in one platform instead of juggling a separate system and login per state.

Book a 20-minute call. We'll walk through your programs, states, payers, and current setup, and show you exactly how Statewise handles your EVV and billing requirements - not a generic demo.